Aspergillosis, allergic bronchopulmonary
Allergic Bronchopulmonary Aspergillosis (ABPA) Allergic Bronchopulmonary Aspergillosis (ABPA) is a complex hypersensitivity reaction that occurs in response to colonization of the airways with the fungus *Aspergillus fumigatus*. It primarily affects individuals with asthma or cystic fibrosis. This condition is characterized by an exaggerated immune response to the presence of the fungus, leading to inflammation and damage to the lungs.
Pathophysiology[edit | edit source]
ABPA is caused by an immune-mediated reaction to *Aspergillus* antigens. The pathophysiology involves a Type I (IgE-mediated) and Type III (immune complex-mediated) hypersensitivity reaction. The presence of *Aspergillus* in the airways triggers an immune response, leading to:
The immune response results in the release of inflammatory mediators, causing damage to the bronchial walls and leading to the clinical manifestations of the disease.
Clinical Features[edit | edit source]
Patients with ABPA typically present with:
- Wheezing
- Cough
- Expectoration of brownish mucus plugs
- Recurrent pulmonary infiltrates
- Asthma exacerbations
In severe cases, patients may develop bronchiectasis and fibrosis, leading to chronic respiratory impairment.
Diagnosis[edit | edit source]
The diagnosis of ABPA is based on a combination of clinical, radiological, and immunological criteria. Key diagnostic features include:
- Elevated serum IgE levels
- Positive skin test for *Aspergillus* antigens
- Presence of *Aspergillus* precipitins in serum
- Radiological findings of bronchiectasis and pulmonary infiltrates
Treatment[edit | edit source]
The management of ABPA involves:
- Corticosteroids: To reduce inflammation and control acute exacerbations.
- Antifungal therapy: Such as itraconazole, to reduce fungal load.
- Bronchodilators: To manage asthma symptoms.
Long-term management focuses on preventing exacerbations and monitoring lung function.
Prognosis[edit | edit source]
With appropriate treatment, the prognosis for patients with ABPA is generally good. However, chronic cases may lead to progressive lung damage and respiratory failure if not adequately managed.
See Also[edit | edit source]
External Links[edit | edit source]
- National Organization for Rare Disorders
- [American Lung Association](https://www.lung.org)
NIH genetic and rare disease info[edit source]
Aspergillosis, allergic bronchopulmonary is a rare disease.
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Contributors: Prab R. Tumpati, MD
